Pectus excavatum (PE), also called sunken or funnel chest, is a congenital chest wall deformity which is characterized, in most cases, by a deep depression of the sternum. Very often other problems can accompany this condition, like scoliosis and breathing issues. The correction of pectus excavatum (PE) and similar chest deformities has two main goals. Using the minimally-invasive Nuss procedure, one or two metal bars are placed to change the chest geometry which, in most cases, effects a positive result on a patient's physiology. Secondly, subjective aesthetic improvement may be achieved.
According to the Nuss procedure, incisions are made under the skin in the lateral chest wall at each lateral side of the patient and a skin tunnel is raised from the incision to the top of the pectus ridge. A tool known as a pectus introducer is inserted through the incision and used to create a tunnel for the pectus bar. The pectus introducer is advanced under the sternum and then through the opposite lateral incision. The pectus bar is shaped to fit the patient. The pectus bar is then inserted through the tunnel, with the convexity facing posteriorly. The pectus bar is then inverted to raise the sternum and anterior chest wall. The pectus bar is secured in place, for which one or more stabilizers can be used, and the incisions are closed.
The pectus bar remains in the patient for a treatment period lasting about 2 years or until the physician determines that the correction is complete and then is removed. Tissue grows around and in some cases directly adheres to the pectus bar, making removal difficult. Currently, surgical tools for removing the bars have proved inadequate for many surgeons.